Individual provider Active NPI

Jeff Priddy, COTA

  • Occupational Therapy Assistant
  • Glasgow, KY
National Provider Identifier
1497201453
Registry record updated Aug 30, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
135940 Issued in KY
Practice address
109 Homewood Blvd
Glasgow, KY 42141-3468
Phone
(270) 651-6126
NPI assigned
Aug 30, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 135940 KY Primary

Addresses

Primary practice location

109 Homewood Blvd
Glasgow, KY 42141-3468

Mailing address

109 Homewood Blvd
Glasgow, KY 42141-3468

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
135940KYMDOccupational Therapy Assistant

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1472515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472515200000",
    "number": "1497201453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 HOMEWOOD BLVD",
            "city": "GLASGOW",
            "state": "KY",
            "postal_code": "421413468"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 HOMEWOOD BLVD",
            "city": "GLASGOW",
            "state": "KY",
            "postal_code": "421413468",
            "telephone_number": "270-651-6126"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRIDDY",
        "first_name": "JEFF",
        "credential": "COTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-08-30",
        "last_updated": "2016-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "KY",
            "license": "135940",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glasgow, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.